Commentary

What your office says to patients


 

The article “A PEARL of wisdom about ‘Pearls,’” (Pearls, Current Psychiatry, September 2009) inspired me to share my own. After 35 years of clinical practice, my office décor has changed many times. In my early psychoanalytic days, it was simple and devoid of any personal references in order to be a “blank screen.” Later I learned that Freud had archeological pieces in this office, some of which he would fondle during his sessions.

In my community psychiatry days, my office contained cultural artifacts, such as Mexican yarn paintings and Hmong story cloth, to display my interest in the ethnic backgrounds of my patients.

When I was medical director of a private psychiatric hospital, my office was large with plush carpeting and fancy furniture. That arrangement seemed to give me extra respect but also created envy.

I now work part-time in a prison. The office is bare and spare, and my seat is closest to the door. In this setting, instead of looking around the office patients look at what I’m wearing.

In my academic office, untidy stacks of books are prominent and pictures of my grandchildren are on view. The computer is usually on.

There’s not much literature and no double-blind studies on office décor. Here are my thoughts:

  • Patients pay attention to your office, especially when you are diverted by writing a prescription. Your office needs to be a sanctuary and feel comfortable and safe. Flexibility in where a patient may sit can help.
  • Decorate your office to convey ideas or concepts that you think will be most helpful to your patients.
  • Patients will view the office as an extension of you and it can affect the therapeutic alliance. Plants that are thriving may symbolize your healing abilities. Watch for unnecessary countertransference, such as a prominent clock that conveys your frustration with 15-minute med checks.

H. Steven Moffic, MD
Professor of psychiatry
Medical College of Wisconsin
Milwaukee, WI

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